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� <br /> . . <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STRFET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ���� l> 17�2t.t�Jc.oG� �lvL —Vc_tl� <br /> PROJECT ADDRESS <br /> (��1������ P��d t�C t�r�s �.� r� � L��k�...z �k �ga�s <br /> Owne� Mal�Addross Cily State2ip Phone <br /> Tenanl Mail Addrass City Slale/Zip Phone <br /> �/C.:.�.c�.�� �1r�[v�� ��Z`%�vc D ��l�o 5,.�1.�,�.�:,:.1„ � J� `1Sa96 �25330`Io?(o <br /> Eleclrical Conlraclor Mail Address City Stale2lp Phone <br /> � 1 �9l�ti� <br /> State License Number Conlract Price of Work <br /> Proposed Uso of Building Contacl Person (Plan Review) <br /> Description o(Work lo Oe Done: �P_��d✓2�c, ��cJC'A� �lC'__ <br /> NOTE: WIRIIJG IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN R,4CEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily fhnt 1 havo read and examin^d fhis applicalion anJ know the same to bo truo and <br /> conecL All pravisions olla�vs and ordinancos goveming fhis type ol work will bo complofed <br /> whether specified herein or noL The granfing o/a pemid does nof presume fo give authonty fo <br /> violato or cancel the provisions ol any other state or local lnw reguleting consWction or fho <br /> perfomrance o(construction. Thof I am aathonzed b}�the arner o/fhis property fo pedomi fhe <br /> work for�vhich opplicafioJi is n�ade and I comply�vith fhe State Confracfors Law 18.2?FC W ond <br /> 296.200 WAC. i <br /> � � <br /> �" <br /> � ' � -�-�_- � , �� � ( l� <br /> � t-,�� - <br /> ignalure Date � � � <br />